S · Squarely face
Turn toward the client. A slight angle can feel less intense for some people.
Lesson · Counseling and helping relationships
Counseling Microskills
Every counseling theory runs on the same building blocks: attending, asking, listening and responding with care. This lesson walks up Ivey's microskills hierarchy, from eye contact to confrontation, and shows how empathy, the working alliance and cultural humility make the skills work.
Microskills hierarchyName-that-skill trainerFeeling word builderBroaching cultureLesson plan20-question check
Start here
The microskills hierarchy
Allen Ivey's hierarchy builds from the base up. Ethics, multicultural competence and wellness are the foundation. Choose a level to explore it.
Being present
Attending behavior
Attending tells clients "I am here with you." Ivey names four parts, sometimes called the three V's plus B: visuals (eye contact), vocal qualities, verbal tracking and body language. Egan's SOLER is another way to remember it.
O · Open posture
Uncrossed arms and a relaxed stance signal openness.
L · Lean in
A slight lean shows interest, without crowding.
E · Eye contact
Comfortable, culturally appropriate eye contact. Norms differ: in some cultures, less direct eye contact shows respect.
R · Relaxed
A calm presence helps clients settle. Notice your own tension.
Hearing the story
The basic listening sequence
These skills draw out the client's story before any advice or interpretation.
| Skill | What it does | Example |
|---|---|---|
| Open questions | Invite detail and exploration; often begin with what, how or could. | "What has this week been like for you?" |
| Closed questions | Gather specific facts; answered in a word or two. | "Did you sleep last night?" |
| Encouragers | Short words or nods that keep the client talking. | "Mm-hm." "Go on." |
| Paraphrasing | Restates the content in fresh words. | "So the new job means longer hours and less time with your kids." |
| Reflection of feeling | Names the emotion the client expresses or implies. | "You sound worn out and a little resentful." |
| Reflection of meaning | Connects the story to values and what matters. | "Being there for your kids is central to who you are." |
| Summarizing | Pulls together several themes, often at the start or end of a session. | "Today we talked about work, your sleep and how much you miss your family." |
Practice
Build a reflection of feeling
A strong reflection names a specific feeling at the right intensity and ties it to the situation: "You feel ___ because ___." Choose a feeling family and intensity to see words you can use.
Moving toward change
Influencing skills
Confrontation
Gently points out discrepancies between words and actions or between two statements. "You say it's fine, yet you've missed three classes this week."
Immediacy
Talks about what is happening between counselor and client right now. "I notice you've gotten quiet since I asked about your father."
Self-disclosure
Brief, purposeful sharing that serves the client's goals, then returns the focus to the client.
Reframing and interpretation
Offers a new way to see the situation. "Your stubbornness might also be the persistence that got you through college."
Information and advice
Useful when requested and timely. Ask permission first in motivational interviewing: "May I share what has helped others?"
Motivational interviewing (OARS)
Open questions, affirmations, reflections and summaries that evoke the client's own reasons for change.
Practice
Name that skill
Read the client statement and the counselor's response, then choose the skill.
What makes skills work
Empathy, the alliance and cultural humility
The working alliance
Bordin's alliance has three parts: agreement on goals, agreement on tasks and an emotional bond. A meta-analysis of nearly 300 studies found the alliance consistently predicts outcome.
Empathy
Accurate empathy is one of the strongest relationship predictors of client improvement.
Broaching
Day-Vines and colleagues describe broaching as the counselor's deliberate invitation to discuss race, ethnicity and culture: "I'm wondering how being one of the only Latina nurses on your unit shapes this."
Cultural humility and missed opportunities
Clients rate counselors as more culturally humble when cultural topics are explored rather than missed, and missed opportunities are linked to weaker outcomes.
Watch and read
Videos and recent research
Videos and peer-reviewed articles published in 2016 or later. Links need an internet connection.
Videos
10 ways to have a better conversationCeleste Headlee · TEDxCreativeCoast · 2015
Open questions, listening and staying present, in everyday language.
5 ways to listen betterJulian Treasure · TEDGlobal · 2011
Simple exercises for conscious listening, a good warm-up for attending skills.
Peer-reviewed articles
- Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.The alliance predicts outcome across therapies and settings.https://doi.org/10.1037/pst0000172
- Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399–410.Empathy is a medium-sized predictor of client outcome.https://doi.org/10.1037/pst0000175
- Hill, C. E., Knox, S., & Pinto-Coelho, K. G. (2018). Therapist self-disclosure and immediacy: A qualitative meta-analysis. Psychotherapy, 55(4), 445–460.When and how self-disclosure and immediacy help.https://doi.org/10.1037/pst0000182
- Owen, J., Tao, K. W., Drinane, J. M., Hook, J., Davis, D. E., & Kune, N. F. (2016). Client perceptions of therapists' multicultural orientation: Cultural (missed) opportunities and cultural humility. Professional Psychology: Research and Practice, 47(1), 30–37.Missing cultural opportunities lowers perceived cultural humility.https://doi.org/10.1037/pro0000046
- Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E. F., Tonigan, J. S., & Moyers, T. (2018). A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change. Journal of Consulting and Clinical Psychology, 86(2), 140–157.MI-consistent skills are linked to more client change talk.https://doi.org/10.1037/ccp0000250
For instructors
Lesson plan preview: Skills before techniques
A ready-to-teach skills lab with triads, recorded practice and feedback.
Sources
References
- Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260.
- Day-Vines, N. L., Wood, S. M., Grothaus, T., Craigen, L., Holman, A., Dotson-Blake, K., & Douglass, M. J. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process. Journal of Counseling & Development, 85(4), 401–409.
- Egan, G., & Reese, R. J. (2019). The skilled helper (11th ed.). Cengage.
- Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399–410.
- Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.
- Hill, C. E., Knox, S., & Pinto-Coelho, K. G. (2018). Therapist self-disclosure and immediacy: A qualitative meta-analysis. Psychotherapy, 55(4), 445–460.
- Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2018). Intentional interviewing and counseling (9th ed.). Cengage.
- Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press.
- Owen, J., et al. (2016). Client perceptions of therapists' multicultural orientation. Professional Psychology: Research and Practice, 47(1), 30–37.